Photo of a woman receiving a mammogram by BSIP/UIG via Getty Images.
When it comes to mammograms, Candace Furlong is about as well-informed as a patient can get.
She’s a nurse practitioner. She’s a regular reader of medical journals. And she knows her breasts are fibrosystic — they contain non-cancerous lumps that make it harder to identify tumors without a mammogram.
So Furlong, now 62, has been confidently receiving the test every 12 months for the past 30 years. But the steady march of contradictory studies recently has shaken even Furlong’s belief in yearly mammograms.
It started three years ago, when the influential U.S. Preventive Services Task Force released a report saying that routine mammograms between the ages of 40-49 can lead to overdiagnosis and the eventual treatment of cancers that would never cause harm. The panel recommended that women hold off on mammograms until age 50 — unless otherwise advised by a doctor — and then receive the test every other year after that.
The American Cancer Society and a number of other advocacy groups immediately advised women to disregard the Task Force recommendations, saying that yearly mammograms starting at 40 are one of the primary reasons breast cancer deaths have fallen so dramatically in recent years.
“With its new recommendations, the [Task Force] is essentially telling women that mammography at age 40 to 49 saves lives; just not enough of them,” Dr. Otis Brawley, chief medical officer for the American Cancer Society, said at the time.
The debate flared back up in recent days when the New England Journal of Medicine published a report featuring three particularly startling conclusions: Routine mammography has led to the overtreatment of about 1.3 million in the last three decades, nearly a third of women diagnosed with cancer wouldn’t have developed the full-blown disease, and “screening is having, at best, only a small effect on the rate of death from breast cancer.” Critics — and there are many of them — call the study “flawed” and “misleading”.
One thing’s certain: the confusion the debate has caused is enough to make Candace Furlong and many women who have far less knowledge of health care absolutely dizzy.
“I’ve been very frustrated and was certainly more confused,” Furlong said. She decided to stick with the yearly tests after a discussion with her doctor at the University of California – Davis, “but as a health professional, I’ve been feeling like there isn’t a definitive answer out there — that there isn’t real clear guidance.”
On Tuesday evening’s PBS NewsHour broadcast, health correspondent Betty Ann Bowser heard from leaders on both sides of the debate and looked at what women should do when the health profession divides on such a high-stakes issue. Watch the full report here.
First, brush up on the numbers underpinning the debate with our infographic below. Click here for a larger version.
NewsHour health correspondent Betty Ann Bowser’s full broadcast report: “Are Annual Mammograms Necessary? Physicians Debate Tool’s Prevention Capability”
Dr. Sandra Swain, president of the American Society of Clinical Oncology, describes why she believes yearly mammograms continue to be so important for most women 40 or older.
Dr. Archie Bleyer, co-author of a recent New England Journal of Medicine report showing mass overdiagnosis of breast cancer, describes why he believes yearly mammograms can cause more harm than good.
- Dr. Barnett Kramer, director of the National Cancer Institute’s Division of Cancer Prevention, explains the costs and benefits of mammography that he says every women should consider before making her own decision.